Credentialing Specialist ( Remote )
Benefits
- Bonus based on performance
- Training & development Job Title Remote Credentialing Specialist Company The Heart Institute of Venice Location Remote (U.S. Healthcare Experience Required) Position Type Full-Time / Part-Time Overview The Heart Institute of Venice is seeking a detail-oriented and experienced Credentialing Specialist to join our growing team. This role is responsible for managing provider credentialing and recredentialing processes to ensure compliance with regulatory and payer requirements. The ideal candidate will have strong knowledge of U.S. healthcare credentialing procedures and excellent organizational skills.
Key Responsibilities
- Manage end-to-end credentialing and recredentialing of healthcare providers (physicians, APRNs, and allied health professionals)
- Prepare and submit credentialing applications to insurance payers, hospitals, and regulatory bodies
- Maintain accurate and up-to-date provider records in credentialing databases
- Track application statuses and follow up with payers to ensure timely approvals
- Ensure compliance with CMS, NCQA, and state-specific credentialing guidelines
- Coordinate with internal departments (HR, billing, and compliance) for provider onboarding
- Monitor and manage expiable documents such as licenses, DEA certificates, malpractice insurance, and board certifications
- Assist with audits and maintain credentialing files in accordance with organizational standards Requirements (Mandatory)
- Proven experience in U.S. healthcare credentialing (minimum 2 years preferred)
- Strong understanding of payer enrollment processes (Medicare, Medicaid, and commercial payers)
- Experience with CAQH, PECOS, and NPPES systems
- Excellent attention to detail and organizational skills
- Strong written and verbal communication skills
- Ability to work independently in a remote environment Preferred Qualifications
- CPCS (Certified Provider Credentialing Specialist) certification is a plus
- Experience working with cardiology or specialty practices
- Familiarity with credentialing software and EMR systems Benefits
- Competitive salary based on experience
- Supportive and collaborative team culture
- Opportunities for professional growth How to Apply Interested candidates are encouraged to submit their updated resume along with a brief cover letter outlining their credentialing experience. This is a remote position. Apply To this Job